What a difference four weeks have made. It was only four weeks ago that Bob and I were last at St Oswalds hospice. The difference is amazing - Ryan has put on over five pounds in weight and was relaxed and alert for most of the time. He was suffering from loads of secretions for 50% of the time but this did not appear to upset him too much. Although we got no proper smile, we did get plenty of eye contact and he displayed a lot of interest in what was going on around him. The only downside was the short time that he caught a tooth in what remains of his lip ulcer. This caused him a lot of pain. 
I have photos taken by carer Sarah, Bob and myself and will print them over the next few days.